Nursing
—–14/05/2018 3:27:22 PM—–
Eslick Haem, Renee
G2P1
30/40, EDD 22.7.18
Referred for extensive SVT in pregnancy (13cm) in setting of varicose veins
No varicose veins prior to pregancy
First pregnancy 3 years ago, uncomplicated.
Hoping for NVD.
Family Hx:
Mother and cousin both have varicose veins
Planning to deliver at Campbelltown Hospital.
Not planning an epidural at this point in time. (did not have with first baby)
Midwife
Jo – Camden Hospital (midwife)
GP: Picton Medical Centre
Obstetricians at Camden Hospital
cc letter to patient
Plan:
Compression maternity stockings
Reduce dose to 40mg daily
Continue for rest of pregnancy and six weeks postpartum (in view of extent of SVT)
Withhold at any sign of labour
No need to see again in clinic unless new concerns arise
Needs to see OB at Camden prior to delivery
meredith.todd@me.com
Nelson Haem Reg, Anna
Delightful pregnant lady seen in AHU for above knee SVT
G2P1, uncomplicated pregnancy to date
PMHx: Mild varicose veins,
No previous clots
FHx:
Nil maternal history of clots
She is an IVF baby with a unknown father – ?paternal history
Social
Teacher – 2 days a week
Non-smoker
Non-drinker
Lives at home with partner and 3yo child
History
Last 3 weeks has developed pain over the anterior aspect of the thigh just above the knee, associated tenderness
Ambulatory but sometimes pain on mobilisation (improved following clexane administration)
No shortness of breath or chest pain
No recent illnesses, no cancer red flag symptoms
Does get migraines (normal for her)
Examination
Some bruising and palpable clot above knee, lower thigh on the left
No oedema in the leg
No calf tenderness
US report: occlusive superficial venous thrombosis involving an anterior lower thigh varix (anterior saphenous vein tributory), extending from the patella to an upper limit of 13cm above the knee crease
Bloods – unremarkable aside from mildly elevated DDimer
PLAN
As discussed with Dr Hsu
Clexane 80mg daily
Review in clinic in 6 weeks with repeat scan
Danny is not here – Dr Eslick will review